"A Mother's Reckoning A Sunday Book Review by Sue Kebold The New York Times

​This post is continued on from the previous post. ​It is an article from The New York Times where you hear the voice of Susan and what she has personally experienced and potentially triumphed over the years.

After watching the 20/20 interview with Sue Klebold, I felt deeply saddened for all the human pain she had endured over the past 15 years since her son's passing. Her son committed suicide along with his friend Eric Harris who went on a shooting rampage in Colombine high school killing 13 and injuring 21 students.

After this incident, it was Sue who received most of the blame for her 17 years old actions as she was the mother and "she should have seen the warning signs. She should have been a better parent. She should have had better communication."The Colombine community and the world had hundreds of "shoulds" for Sue and even Diane Sawyer(interviewer) had clear judgment on her face for the mother openly and honestly crying before her. The reality is that Sue didn't know a shooting would result from what seemed like your normal teenage behavior.

Being a religious woman Sue prayed and prayed for forgiveness over years and years contemplating her own suicide. Sue felt responsible for her the killings of her son and continued to dwell in the loss of these people and what she could have done.

When listening to her speak, this was a genuine person, a believer, a woman with good intention, faith, and love for her children. Her eyes were open, providing advice, discipline, asking questions, and providing her unconditional love. A secretive teenager living a separate life behind closed doors is not something a mother can always control or know. A teenager who presents with normal behavior, positive academic achievements and happy in his present self. Mental illness was not discussed in classrooms, hidden behind closed doors, and people dismissed strange behavior as a kid just going through the motions. How could this mother know?

While she endured extreme grief, sadness, pain, and scrutiny from others over the years, it was her present self that was the saddest part. She wrote a book, which served as a great cathartic release and education for mothers. Although, over all the time, the prayers, the solitude-she still didn't truly forgive herself. There were ounces of anger and disappointment and sadness that were present in her demeanor, her words, expression, and verbal language. It was a woman who couldn't let go, forgive, and move on and she was torn apart my grief-torn apart by a crime her son made the decision to commit with an extremely mentally troubled boy- Eric Harris.

This woman, Sue Klebold, deserves to authentically start over rather than still live in memories and pain. While healing may take a lifetime, there is a big step to forgiveness that can help lift her spirit to happiness rather than a dark cloud taking over her days.

Today, my thoughts are with this woman and I pray for her as she deserves to get her life back and find joy. She said her joy was taken away, but.....it can be found again.

Keep the faith and live life with a positive hope for a better tomorrow. PCR

What if you could get what a psychologist offers without actually having to see one? Many people enjoy the warm, caring relationship provided by a mental health clinician, but others simply want to get better. Many people would rather not open up to another person about their problems — at least, not in person. Plus, seeing a mental health clinician can be inconvenient and expensive — and there might not even be any nearby.

One of the new frontiers in psychotherapy is using the Internet to deliver cognitive behavioral therapy (CBT) for depression, anxiety, and other behavioral health problems in a way that reduces — or sometimes eliminates — the amount of time spent with clinicians in person. This novel delivery method allows treatments that have traditionally been provided one-on-one to be scaled up so they can reach far more people. After all, it doesn’t matter if a good treatment exists if people don’t have access to it.

What are these online therapies?The field is new, so the data about these online programs are sparse — but a team of British researchers recently conducted a review of the available literature. For the review, they scoured medical journals looking for “John Henry” studies — that is, comparisons of live cognitive behavioral therapy against websites or computer programs that deliver treatments for anxiety or depression.

What did the researchers find? They used a high bar of scientific rigor and found only five online mental health interventions that had been directly compared with live clinicians providing the same treatment, for working-age adults. Two of the interventions were Australian and three were Swedish, and all of them were for social anxiety or panic disorder.

Most online interventions studied by the researchers were divided into sessions, mirroring the way in-person CBT is delivered on a weekly basis. All of the online therapies delivered treatment via written content, also known as “bibliotherapy.” This was combined with communication with a mental health clinician, usually a psychologist, over email or private messaging systems. In one study, psychologists were limited to spending only 10 minutes per week on each participant. Some programs added text messaging and discussion forums, and most included homework — things that participants did between sessions — just as in-person CBT involves between-session practice.

All treatment groups, for both in-person and online CBT, significantly improved in symptoms. One study found better outcomes for the online treatment, and the others found equal results between the two types. The online treatments required much less clinician time, making them more cost-effective.

The downside? All of the online treatment participants needed to do a lot of reading, which can be a limiting factor for some people. Also, written interaction with a psychologist or other clinician was part of every online intervention in this review. This means that to some extent, the effectiveness of the intervention still depends on the clinician who’s on the other end. Plus, requiring clinicians to be involved at all creates a hurdle to scaling up treatments to reach massive numbers of people.

The newest innovations in a very new fieldNew online programs and mobile apps are emerging that minimize the amount of reading, use video and audio to deliver treatments, and require no clinician involvement at all. These simulate live CBT but can be delivered to huge numbers of people. Head-to-head comparisons of these newer programs against traditional therapy (the kind of comparison that would meet the criteria of the British team) have not yet been published. So stay tuned for developments in this next generation of treatment delivery.

In the field of Mental health, there will often be speakers to speak about healthcare, policy, living with the disorder, families impacted by illness, how to cope etc. It has been a long term observation of mine that there seems to be a few types of professional speakers with illness: those who inspire and empower the patient, those who educate/provide research, and those who speak to the professional audience of clinicians.

Of course there can be overlap between the speakers with some utilizing all three. Although, I observe a distinct separation between speaking to those with Mental illness and those who are purely sharing success, professional achievements, and research. For instance, we have Doug-Doug is a leading physician who was diagnosed with bipolar disorder and shares passion for stigma on the Mental health population and shows images and stats and more images. His accomplishments are highlighted. He shares his diagnosis in the middle with mild emotion and a bit about the past difficulties he faced. You feel something and then you hear about the award he won for at a famous Mental health event in Germany. The symptoms are being briefly being addressed and then masked by the accomplishment.

Also, it seems to be targeting colleagues rather than patients. Do his fellow attendees with Mental illness who are functioning on an "average" level need to hear about all the awards and accomplishment. Is it necessary to prove that he overcome illness times 100 rather than just 10? It's also important to note a lack of emotion. When speaking briefly about the illness in between the success, where was the emotion? It was clearly repressed as the event of illness was placed behind him.

A great example of utilizing emotion would be the "Ted Talks." The Ted Talks consist of some of the greatest minds in the world. The number one most important factor is "emotion" according to Carmine Gallo of "Talk like Ted." These speakers have a choice to give emotion or to focus on everything else, but emotion. It does not come easily to everyone and it is normal for people to utilize their strengths and fear their weaknesses. A speech needs to be humanized and the greatest researcher or psychologist may not be able to nail that component rather it takes removing the layers of achievements to get down to the skin and the heart.

Let's continue on with our speaker Doug. He is lacking emotion, but he wins over a large majority of the audience. Are they clapping because achievements or are they clapping because of his story or both?

Speakers usually have their name and profession on a pamphlet or a description can be found on the internet. If you are an educated speaker with BP disorder-is it necessary to emphasize your accomplishments? The average person with Bipolar disorder is not over the top successful. "Successful" meaning multiple degrees, educator, world leader, medical doctor, and author. That would be the National definition of successful. If the average person is just holding onto a job or living off public assistance-how does he feel? Is this inspiring or discouraging to one with BP disorder?

Many people who are speaking to clinicians, politicians, and advocators they may be overcompensating on their need to convey success with consideration of these people to impress. It's important to note that speakers with illness do need to speak about certain issues in regards to policy, updates in research, and relative material. But what percentage of that needs to be present in comparison just spending ten minutes on symptom management and how illness is currently impacting the speaker.

A common name one may know is the author Kay Redfield Jamison. A psychiatrist who was diagnosed with Bipolar disorder in her early twenties. The book is fantastically written and a bestseller, but the woman overcome her sickness to keep rising to the top of the ladder. In all fairness, she is speaking the language of clinicians and to patients. For the average patient of mine reading that book or relating to her speech-not happening.

Eleanor Roosevelt says, "No one can make you feel inferior without your consent." In all honesty, I believe that the Bipolar population in under privileged areas would feel inferior. "If she keeps moving up the mountain, how come I keep slipping down?"Those words I just hear ringing through my ears as it's a bit of a pill to swallow-have a disorder and professionally soar to the top. Do symptoms just disappear after a certain age? Dr. Jamison went through symptoms of her early adulthood, but then it just all turned into professional growth.

Carmine Gallo says and I say, the human component and "meeting someone where they are" is important rather than a race to have the most credentials and achievements mentioned in one speech. How about a speech with no credentials or professional achievements made? Only family and illness improvements or developments. You just walk out your door and you leave it all behind you to speak as an advocate and a great doctor with knowledge and expertise, but you use it in the most effective way to relate to both clients and professionals. This is the skill to inspire and touch the clinician while making the Bipolar patient feel included.Lastly, it is recommended to utilize realistic symptoms and connect them to difficulties. There is a difference between saying, "I got divorced and now I am happily remarried" to "The Bipolar interfered with my interpersonal relationships including my marriage. I am married now, but I still difficulties with friendships. I take a note book to write good my wife and friends." Make the disorder practical and be creative when making the choice to speak. While it is normal to repeat a speech, the past incidents of experiencing bipolar disorder just seem typical and rehearsed.

In comparison to stigma, it is quite different because stigma is encouraging emphasize on the self. Speaking with achievement is about making more direct comparisons between diagnosis and achievement. If a person knows how to get to the top spanning twenty years, not a five year, bad few years-that would be helpful.

There is recognition that it is still painful for a professional to open up about their diagnosis and it is common to overcompensate. It could be easier to brush over the emotional component and real "you" underneath the gold stars or it could be easier with easy to identify with your illness first and the accomplishments are just great additions.

When hanging out at the Fisherman’s wharf having this conversation about the homeless population and their interaction with tourists-I heard shouting and told him “Excuse me.” I walked over in front of the bakery to find an African-American pushed to the ground by two police officers. They were holding him down waiting for back-up, which apparently included ten other police officers. Most of them appeared to be rookies as I could identify from their facial expressions and confirmed from the cop I was standing right next to-nice guy, maybe fifty five, looked like the cute guy on Chopped.

Priscilla has to bluntly ask, “Do you guys really need ten people to hold him down?”

He responds, “Yes, we do. The guy just broke through a locked door and he is intoxicated along with using drugs.”

I said, “Oh I didn’t think it was that serious.”

We shared our disappointment with the system that puts police at the front line of Mental illness without any proper training. These poor rookies had no idea what to do with this man, as that is not what they signed up for. Of course, they have to deal with this population, but on a daily basis as much as a social worker might visit a client. Police officers are underestimated for all the work they have to do not even involving crime especially with the constant arrests and hospitalizations with this population.

This guy, Richard, said he’s been on the force for thirty years and he is about to retire. He has seen it all when it comes to the panhandling, drug use, theft, and crime on the streets. Average people who couldn’t make the bills, lost their job, or had an addiction problem-the streets took them in and they stayed committed to that lifestyle.Many don’t have interest in “getting a job and having an apartment.” The street is a preferred choice for them. Richard did express concern for this population as the system has not correctly addressed this problem for years except by engaging in control and giving them $400 a month to solve the problem. Money cannot buy the homeless out of their problems. PCR

As ten of them were struggling to keep him on the ground, I understood why they needed ten people. He kept complaining about his leg, but there was not one indication that they were mistreating him at all. Richard got a call and left, therefore, I decided I would try and speak with four or five of them to have an open, honest discussion about their job empathizing and thanking them for their hard work. The 45 year old man had already been placed in the stretcher and they were just interviewing the restaurant owner.

When I asked how many hours of Mental health training, they reported 40 hours of training when they start the job. What training do they receive when these real experiences are happening and they need to discuss them to learn about symptoms and identify similar patterns-NONE. Receiving forty hours of Mental health training is great for a starter, but the learning needs to a professional, educational, and social setting. When they show you how to break in a house, they should show you how to address a homeless man who is high on meth.An idea I believe in is focus groups once a week with 5-8 officers to share these cases, identify symptoms, situations, background information etc. If an officer has the experience, takes some notes, and then processes these encounters with others-it makes the process easier.

This is just a serious problem that we have no control over.”-Brian-

The Mental health system also has its fair share of work to do in regards to collaborating with the police. The police follow their protocol to bring this man into the hospital. He is unmedicated, has an illness, give him a prescription and he signs himself out. The hospital is supposed to be “the cure,” but when it comes to the Mentally Ill-many of them know how to work the system and it’s not to their own benefit.

This could be broken down with clearer specifications, but the point being made is that these officers shared honestly their inability to help this population. They get their training, they follow protocol, but at the end of the day-they just don’t get it. They share stories with their loved ones about the “crazy guy” they arrested today. The negative labels and the stigma continues to get worse. Why? The lack of education and experience that is broken down and processed overtime.Mental illness is not easily understood and for them being twenty five years old and thrown into a job that deals with this population everyday-it’s tough.

Thank you police in San Francisco for being kind and doing your best. It’s not easy work, but you are appreciated for working on the streets of SF with constant harmful activity.

When we hear the school or name "Stanford" automatically we may think two things: money and intelligence. For Nev Jones, this was not about money, but it was about intelligence, persistence, and true resilience.

Standing at a mere 5'3 and quite petite, she stand to the side of the podium just in the beginning of sharing her deepest and darkest secrets. Nev happened to have a parent diagnosed with Schizophrenia and had to spend a significant amount of physical and mental time caring for her mother. It was emotionally draining, but she always had her studies to focus on. Nev had what every program wanted and was except to the twelve or more Doctoral programs she was accepted to in the country.

She chose one school(name confidential), but things took a sharp turn when symptoms of Schizophrenia started to appear. The school took notice, the school humiliated her, they expelled her, and labeled her as "incompetent" when her grades were perfect. All of her friends turned on her and she had no activities left to attend.

It was the stigma of Mental Illness that was getting in the way of Nev's future....​After a deep depression and a psychotic episode, Nev received a random invitation from another program who were unaware of her illness. With support, medication, and not giving up-Nev is now a top researcher at Stanford for research of illness and educational impact. She has proven in her determination and now with research that things have a strong potential of shifting in the direction of Mental health with advocacy and increasing numbers.

This young woman is quite an inspiration. When it came time for questions a man even randomly asked, "Are you married? I have a nice son for you." "No response, but hey at least he tried:)

EDUCATING ENVIRONMENTS ARE SUPPOSE TO BE PLACES OF SAFETY...WHAT IS HAPPENING TO US IN THIS SOCIETY?? PCR

During my travels, it is common for me to conduct my own “mini-research” with the homeless population. They are a population that I always look out for and care for because I understand the various reasoning behind their situation and I can meet them where they are as a human when speaking with them. It’s important for me to ask about their well-being, what brought them to the streets, discuss their/our faith, short term goals, find their sources of support, and listen…just listen their concerns, but redirect them to what is positive and what is possible.

This research was important to be conducted in the city of San Francisco, which has one of the highest percentages of homeless people in the nation. It was great to hear feedback from locals whether those in art galleries, working in retails stores, on the bus, or in the hotels. A woman from Argentina, a retired police officer, a taxi driver, a doctor in a hospital-these people not only had awareness into this population, but they had true insight and concern.

San Francisco is the city that welcomes the homeless with “open arms.” It was reported by a retired police officer that they come from all over the state and even the country. There was a variety of answers about this epidemic, but what I mostly heard was that the government does not properly address the problem. They provide approximately $400 contributing to their substance abuse. The police have grown accustomed to this problem that is not being addressed-admit him to the hospital, get released, and back outside doing the same thing. The city does not have enough space for them even if they did want to house them all.

When I asked about their level of violence, they didn’t find them to be violent, but they can act inappropriately in public touching or grabbing at others and not wearing clothing. The locals also reported ignoring this behavior and not providing money to condone this kind of behavior. While there is a liberal approach to treatment with many centers and organizations to help the homeless-there is a missing link between system, person, and organization. This missing link I found to be problematic in my own treatment of this population and/or severely and persistently Mentally ill. A woman demonstrated great concern with this system and how this is impacting the public and local residents of San Francisco. While many people are used to their presence on street corners or passing by talking to themselves-it is still a problem that needs to be addressed rather than just accepted at face value.

What was my role in speaking with the homeless?

New York, Chicago, LA, India, Honduras, etc. I will spend time speaking with the homeless population.I only spoke with a couple homeless people as I actually did have some fear with the San Francisco population.I saw a couple of them aggressively touch tourists on two occasions, which is uncommon for me to witness. They were unlike most homeless I encounter as many appeared to be living in their own world with no idea of where they were or who they are. Some carry carts with all of their belongings, old radio sets, little clothing, and also little begging. I did not witness a consistent amount of begging. It just seemed like they did their own thing and had their friends and sat on the sidelines smoking marijuana or cigarettes.

There was really something different about this population…..It would be very interesting to do a formal research study as there is many factors keeping them on the streets and along with those who recycle themselves through the system leading them to a street life of addiction.

The last day of the conference consisted of our workshops and at the end of the day: the closing banquet. It was a great time to enjoy our three course meal and have closure with all the great people we had met.

Speeches, Awards, and Music.....Award for a judge who created a Mental health program within the Judicial system between clients and families. Award for a Senator in Sacramento fighting for Mental healthcare through policy. Then we have our humorous and kind psychiatrist with the standard closing speech. Music included a young adult who looked like Brad Pitt from "Thelma and Louise" wearing cowboy boots and playing Johnny Cash. He shared his diagnosis of Bipolar disorder and it was quite easy to connect with his emotional lyrics and "Somewhere over the Rainbow."He spoke about his concerns for humanity...for how physical illness takes priority....patients just want to be acknowledged like everyone else. My favorite quote from him was ,"I ain't receive no casseroles or flowers at my hospital bed." He had such great charisma and a positive attitude. He currently visits local hospitals all over the country singing to children. Another inspirational man doing great things with the illnesss he did not choose rather it chose him. PCR

She is a researcher of the Brain at Harvard University who shares her personal story and education with the brain. When you watch her video, your mind is transported to thinking about your brain and how it functions. Even if you don't have interest in the learning all the details about the brain, she makes you interested for twenty minutes to an hour. Dr. Jill had been studying the brain as a passion and career. She especially was interested in studying Schizophrenia as her brother is diagnosed. It was her own stroke that changed her life at age 37 that resulted in having to relearn everything she knew i.e. how to write, read, speak, eat, talk, and walk. She called herself "an infant in a woman's body." It took her approximately 7 YEARS for her brain to recover back to it's normal state.When you can study the brain and then sit and analyze, experience, observe your brain fall apart-it turns out to be a fascinating experience of learning and as Jill titled her book "A Stroke of Insight."

At NAMI, Jill briefly shared her incident and passionately moved onto the brain. The Amygdala vs. the Hippocampus, Right Brain vs. Left Brain, Addiction, Neurocircuitry, and various feeling states/messages sent to the brain.

Do you feel more connected to one side over another? Or Both?Dr. Jill says, "The left brain is dominating society. We need more right brain!"Teenage behavior expected: No Frontal Lobe-Can't plan ahead-High Impulse Control, and Do not Understand Consequences. Brain Not Fully Developed until Age 25

Dr. Jill Bolte Taylor is a true inspiration with an uplifting spirit and charisma towards starting life over and being insightful into the human mind and behavior. She lost it all, but it came back to her ten fold and she is using this experience to make a difference. She is on my Top 100 and the deserves a spot on the Most Influential of Time Magazine.

The speaker, Hakeem Rahim informed us to take out our phone and tweet#Iamacceptance. The problem is I don't have twitter and I don't know how to use a hatch tag(this should create some humor as a two year old might understand how to do it).

Hakeem Rahim is a presenter for NAMI-"Let's talk about illness."It was his bold, confident that captivated myself and I believe the rest of the audience.He shared his story struggling with Bipolar Disorder for fifteen years and recently coming out just two years ago. He was diagnosed while studying at Harvard, times of seeing Jesus, and having events of Mania-running around with too much energy and the ability to perform way too much in short amount of time.